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IMPORTANT NOTES: The instrucaans accompanying this form must be followed. Complete all
parts, checMng the NONE box for each part where you have no reportable information. Sign on la~vt page.
I. POSITIONS. ~t,o,~
5 NONE (No reporlablepoMliom.) POSITION
I. Director
NAME OF ORGANIZATION/ENTITY
William & Alice Mortensen Foundati~
~~ . ~
. ~~
Covello, Alfred V.
Dale of gc~,rt
Page 2 of 1 7
CoYeno, Alfred V.
05/16/201
I11. NON-INVESTMENT IN COME. tR~,,i,g inZi,.i~io,a.,r~,u.~..,e~V,. 1~-~4 of~t~,g ~,~,~,,,~o,~ A. Filers Non-Investment Income NONE ~o reportable non-investment income.) ~
1. 12/31~9
~ ~o~s, ~t s~u~s)
$111,597.~
2. 3. 4.
B. Spouses N on-lnvestment [ncome - if you were m~rried during any potdon of the reporting year, complete thig seaion.
(Dollar amount not required except fi,r honoraria,)
~
1. 2. 3. 4.
IV. REIMBURSEMENTS (lnclutb..~" those to sptnts and dependent childrcm; set~ pp. 2J-2 7 of filing in.ttn~.tiott~.)
NONE (No reportable reimtmrsements.) SOURCE I. 2. 3. 4. 5. DATES LOCATIQN PURPOSE ITEMS PAID OR PROVIDED
DESCRIPTION
3.
4,
5,
1. 2. 3. 4. 5.
Date of R~port
Page 4 of 17
J Covell~Alfred V.
05/16/2010
11)
(J-P)
I (2,
C~ 3
(A-H)j
ot in~)
~mp~a)
I. 2. 3. 4. 5.
6.
Dividend None
A A A
A
7. 8. 9. 10.
I I.
Dividend None
J J J J
M
T T T T
W
B A
C
Dividend lat./Div.
Rent
12.
Rent
Rent
PI
Dividend None
J K
Dividend
I. l~v.,ome Gala Codes: (See Cokmans B I ~ LM) 2. Value Cooler (~: Colurrm~ Cl and D3) (S~ Columa C2)
A ~$1.000 tw h:-,n F *$~o,00! - $100.000 J -$15,000 or less N =$250,(301 - $500,000 P3 -~125.000.001 $50,000,~00 U ~Oodt Val~,~
C =$L,501 - $5,000 HI =$1,000,001 - $5,000,000 L Pl =$1,000,001. $5,fl00,000 P4 ~44ore thta $50000.000 W =Estira~ted
E =$15,001 - $50,000
V =Other
(2)
~int.)
(l)
Valuc
,2) [ M~ C~ 3 (~W)
V~
(I)
Ty~ (.g., ~mp~on)
(2)
(3)
(J-P)
(4)I
(5)
l~nti~ of
~cm~fmmpH~Io~
~e I ~ ~v.,~
(A-H)
~2
(J-P)
buye~/mllcr
(if pffva~
None D A A
A
05/2~09 J
05/28/09 05/28/09 J
07/20/09
23.
DOV
A A A A B
J J J J K
A A A A C
24. EL 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. EMAN EP+C XOM GOOG GS HPQ IBM HON JDSU J-NPR
A A A A
Buy
05/28/09
K J J J A A B
36.
37. 38.
KFT
MON MR/(
A
A A
Dividend
Dividend Dividend
T
Sold 07/20/09 05~8109 J K B
Buy
39. 40.
41. 42, 43. 44. 45. 46. 47. 48. 49. 50. 51.
MS NKE
.NrIAP NTRS NE NVT PG P/~I PTV RTN KIMM SCIIW SWY
A A
Dividend Dividend
None
T Sold
Sold Sold
05/28/09
05128~09 1 !105109 05/28/09
J
J J K
A
A A
A A A A A A A
Buy
(part)
Sold
Sold
1~16/09 05/28/09i
J J
A A
A A
Dividend Dividend
T Sold !05128109 J A
]N.=~+fP~..~p,,m.g
I
!
Corolla, Alfred V.
05/16/2010
B.
In.me du~ng
C.
Gross value at end T~s~tions
D.
ofr~oaing V~ ~ V~ue
T~(e.g.,
l~n,i~of
52.
S~
A A A A A A A
J J J K
A A A
~5. ~C 56. VZ
~ld
05/2g/~
J M J
A A A
~. Julius B~ Iml 61. F+S 62. 63. ~ 5.62~% ST Po~ R~ ~ 5.5% PlAu~Rcv
B A A B A A A A A
07/20/~
J -115,~ ~ less
Q -A~i~l U ~ Value
05/1~/2010
~empt from p~ ~e
~d~
~e 2 ~ 1 (J-P) ~ (A-H)
69. 70. 71. 72, 73. 74. 75. 76. 77. 78.
NKE CT State Gen Rev 4% Stamford CT GO 4% VTI VItT VDC XLE EFG IJK lJJ
A B B A A A A A A A
Divided Interest Interest Dividend Dividend Dividend Dividend Dividend Dividend Dividend
J L L L K
K K K K
T T T T
79. liT
80. 8 I. 82. 83. 84. 85. IJS IWB HYG EMB FXI DBC
A
A A C C A A
Dividend
Dividend Dividend lnt./Div. lnt./Div. Dividend Dividend
K
J K L L K K
T
T T T T T T
Buy
Buy Buy Buy Buy Buy Buy
05/28/09
05/28/09 07/20/09 05/28/09 05/28/09 05/28/09 05/28/09
L K K K
1. lacolm Gain Codes; |Se~ Coltm~s BI ~ D4) 2. Value Cod~ {S ColtmmsCl and D]) 3. Value M~:th~l Cod~ (S~ Column C2)
A -$1.000 or I..:n F -$50,001 - $100,(.~0 l ~$15,000 or les~ N =$250.001 -$500.000 P3 *$25.000o001. $50,000,000 Q - Apl~i "sal O ~Book Value
B -$1,001 - $2,500 G ~$J00,~)l - $1,000,000 K ~$15.001 - $50,000 O ~$500.001 -$1.000.0430 R ~7o~ I,R~al Estat~ Oaly} V .<)ff~r
C =$2.~,01 . $5.000 HI =$1,000,001 - $.$,000.000 L ---~0,001 - $ 100.000 PI ~l;l.O00.001 - $5,000.000 P4 =Mor~ tlum S ~/kssessmmt W ~Estimated
D -$5.001 - $15,000 H2 =Mor~ ~ $5,000,000 M --$ I00.001 - $250.000 P2 -~5.000.001 -$25.000.000 T -~2aCa Ma.q~
E =$15,001 - $50,000
DateafRcport
05/16/2010
.... ~ m/ue, tr .... ctions :lnclua~ those of.spo~t*e and delwnd~nt children; seepp. 3460 of filing instructians.l
86. 87. !88. 89. 90. 91, 92. 93. 194. 95. 96, 97. 98. 99.
PID SCHV XLY" XLB XLK SDY VWO VNQ Schwab Brokerage #2 Schwab MMF ACN AIB BUD ALU
B B A A A B A A
K K K J K K K J
A A A A A A A
K J
] J J J
T T T T
] s=~ofe,~o, ~,o~,~
05/16/2010 I Covello, Alfred
V.
(t)
(A-H)
(2)
or ~C)
(I)
(J-P)
~2)
~e 3
O)
~pfion)
~2)
O)
~4)
(s)
(if private
(J.P) (A.H)
103. EJPRY 104. ABX 105. BCS 106. CIIK.P 107. ABB 108. BAESY A
Sold
08/24/09
109. BHP 110. BZLFY I I I. CCJ 112. CAJ 113. ~YOU 114. CHL 115. LEO 116. CS ! 17. DBOEY 1 lg. DEO 119. EXPGY A A A A A A A A
None Dividend Dividend Dividend Dividend None None Dividend Dividend Dividend Dividend
J J J J J J J J J J J
T T T T T T T T T T T
Buy
02/17/09
J J J J
J J J
_..
A A
Dividend Dividend
None
J J
J
T T
T
Buy Buy
Bu~
06124109 04/21109
06/2.6/09
124. KDDIY
125. KCRPY 126. AIIoNry"
None
None
J
I
T
T
Buy
Buy
06/23/09
06/1 6/09
D[vldend
J J J
J J J
T T T
T T T
Buy Buy
12/2.3/09 J 07/31/09 J
Buy Buy
09/03109 J 04/07t09 J
A A A A
J J J J
T T T T
NONE (No reportable income, assets, or tra~actions.) Description of As~ts (~cl~ng ~st ~mts) Pl~lX)aR~eachas~t ~t t (A-H) Income d~g re~ing pefi~ l~(e.g., or int) Gross val~ at e~ ofr~i~ ~i~ Val~ {J-P) Val~ C~ 3 (~W) T T~e(e.g., redemption) T~s~fions d~ng ~g periM
Date
137. SAP
Non~
Buy
1~1~09
A A A
A A
J J J
J I
T T T
T T
J J J
J
A A
A
Dividend Dividend
Dividend
J J
J
T T
T
Buy Buy
Buy
J J
J
146. SDXAY
147. SLT 148. SUHJY 149. SWBDY
A
A A A
Dividend
Dividend Dividend Dividend
J
J J J
T
T T T
Buy
Buy Buy Buy
05122/09
01109109 till 1/09 ! 08/2 I/(Y:)
150, TLM
151. TSCDY
A
A
Dividend
Dividend
J
I
T
T
Buy
05/08/09
A A
Dividend DMdend
J J
T T
Buy Buy
01/08/091 1~15/09
J J
]r~,mcofe,r,o* ~po~,g
[ Coveil~ Alfred V.
._.
Page 1 3 of 1 7
05/16/2010
VII. INVESTMENTS and TRUSTS - ~o~, ,,.~.. ~ ..... ale.., anclud~ tha.,e of .~U~ ~d demndent childrent ~ee pp. S~60 oyfaing in~tructlon.,.)
NONE (No reportable income, asse~, or transactions.)
& De~ription of ~ B. 1~o~ d~g C. Gross val~ at end ~ D.
~t
Val~ ~e 2 (J-P)
Date ~d~
V~ue ~2 (J-P)
G~n C~ 1
:1 (A-H)
[ (A-H)
J J J J J
T T T T T
Buy
0~07/~
Buy
07/01/~
Sold
0~0~09
I~. TEVA
None
Sold
08/03/09
161. ~Y
None
Sold
09/11/09
162, LOGI
None
Sold
03/I 3/09
163. VE
None
Sold
09/2~09
164. DOX
Dividend
Sold
I~i0/~
165. UBS
Dividend
Sold
~19/~
166. S&N
Dividend
Sold
0~13/09
167. ~M
N~e
Sold
09/2~09
168. CEDC
Dividend
Sold
03/031~
169. OCP~
Divided
Sold
0~i 7/~
170. BZLFY
Dividend
Sold
03103/~
NameofPerton Reporting
-- I
Date of Report
1 Covello, Alfred V.
05/1612010
.ions(Include., those of spa .....d dependent children; see plx 34-60 of filb ~ ;~.lu~, tr ..... W inxtrurat,ns.)
NONE (No reportable income, assets, or transactions.) B. Income during ~:oorting period
(I) I (2)
Date Value Gain mm/dd/yy Code 2 Code I J-P) / (A-it) 1 [ t 11/27/09 07/08/09 09/11/09 07/08/09 02/11/09 07/21109 J J J J J J A A A A A A
(4)
(5)
171. L1-UOY 172. TV 173. NJ 174. SXC 175. SWCEY 176. TEF 177. Schwab Brokerage #5 178. Schwab MMF 179, CT GO 3.5% 180. Pinal County AZ 5% 181..NrY" City 5.25% GO 182. Louisiana ST Co~ec 5% 183. "~T St 5% GO 184. Midland TX5% GO 185. Vernon CT 4% GO 186. Citizens PPly FI Rev 5% 187. Reagan Cty TX 4% GO
A A A A A A
Sold Sold Sold Sold Sold Sold Merged (with line 14)
A A A D B B B C C C
Dividend Interest Interest Interest Interest Interest lntemst Interest Interest Interest
I K M L K K K M M M
T T T T T T T T T T
Page 15 of 17
Covello,
Alfred V.
05/16/2010
V II. INVESTM ENTS and TR USTS - ~co,,,~. ,,,~,,~ ,,~n~,~ao,~, an~t.,~..,,~o~ of .~po~ ..a
NONE (No reportable income, a~e~, or transaclions.)
A. ~s~ipti~ of ~ (i~lu~ng ~st as~ts) Place "(X)" afl~ e~ as~t ~ f~m ~or ~s~e B. ~come d~ng ~ ~d~g pefi~ ~A~t [ ~e I (A-H) Type (e.g., ~v., ~nL or int.) C. G~ val~ ~ end ofr~ ~i~ V~ue ~e 2 {JP) Val~ Me~ ~e 3 (~W) T~ (~.g, buy, sell, r~pfion) D. Tr~iom dining ~n~g p~iod
Date ~d~
~e 1 [ (A-H) ,
Int~st
Inmost In~eg
190. ~ S~5%
In~r~t
turret
Int~st
Buy
~ 11104/~ L
Inter~t
Buy
05/131~
D B C
M K L
T T T
I~~cf~~*R~~ I co,,~u~,^lrred v.
,~.mc,~e~onac~.~.~
Covello, Alfred V.
..
--
Oateort~p,,.
05/16/2010
I certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statutory provisions permitting non-disclosure. I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are la compliance with the provisions of 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations.
Signature _
NOTE: ANY INDIVIDUAL WItO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE TillS REPORT MAY BE SUBJECT TO CIVIL AND CRLMINAL SANCTIONS (5 U.S.C. app. 104)
FILING INSTRUCTIONS Mail signed original and 3 additional copies to: Cotmnittee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Wazhington, D.C. 20544